Value-Based Purchasing performance scores are calculated based on the following four domain scores: Clinical process of care, patient experience of care, patient outcomes, efficiency O Clinical process of care, community opinions, patient outcomes, efficiency Location relative to patients, patient experience of care, patient outcomes, efficiency o Clinical process of care, patient experience of care, patient outcomes, percentage of Medicare patients treated QUESTION 18 Supply Chain organizations involved in procurement include: Manufacturers, distributors, group purchasing organizations, and health systems. Group purchasing organizations, community leaders, and health systems Distributors, group purchasing organizations, health systems, and patients Health systems, patients, group purchasing organizations, and manufacturers QUESTION 19 The healthcare industry in the United States is highly regulated by: Federal government State government Local government